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dc.contributor.authorAngoff, Gerald H.
dc.contributor.authorKane, David A.
dc.contributor.authorGiddins, Niels
dc.contributor.authorParis, Yvonne M.
dc.contributor.authorMoran, Adrian M.
dc.contributor.authorTantengco, Victoria
dc.contributor.authorRotondo, Kathleen M.
dc.contributor.authorArnold, Lucy
dc.contributor.authorToro-Salazar, Olga H.
dc.contributor.authorGauthier, Naomi S.
dc.contributor.authorKanevsky, Estella
dc.contributor.authorRenaud, Ashley
dc.contributor.authorGeggel, Robert L.
dc.contributor.authorBrown, David W.
dc.contributor.authorFulton, David R.
dc.date2022-08-11T08:08:32.000
dc.date.accessioned2022-08-23T15:58:35Z
dc.date.available2022-08-23T15:58:35Z
dc.date.issued2013-10-01
dc.date.submitted2015-10-08
dc.identifier.citationPediatrics. 2013 Oct;132(4):e1010-7. doi: 10.1542/peds.2013-0086. Epub 2013 Sep 9. <a href="http://dx.doi.org/10.1542/peds.2013-0086">Link to article on publisher's site</a>
dc.identifier.issn0031-4005 (Linking)
dc.identifier.doi10.1542/peds.2013-0086
dc.identifier.pmid24019419
dc.identifier.urihttp://hdl.handle.net/20.500.14038/30469
dc.description.abstractBACKGROUND AND OBJECTIVES: Chest pain is a complaint for which children are frequently evaluated. Cardiac causes are rarely found despite expenditure of considerable time and resources. We describe validation throughout New England of a clinical guideline for cost-effective evaluation of pediatric patients first seen by a cardiologist for chest pain using a unique methodology termed the Standardized Clinical Assessment and Management Plans (SCAMPs). METHODS: A total of 1016 ambulatory patients, ages 7 to 21 years initially seen for chest pain at Boston Children's Hospital (BCH) or the New England Congenital Cardiology Association (NECCA) practices, were evaluated by using a SCAMPs chest pain guideline. Findings were analyzed for diagnostic elements, patterns of care, and compliance with the guideline. Results from the NECCA practices were compared with those of Boston Children's Hospital, a regional core academic center. RESULTS: Two patients had chest pain due to a cardiac etiology, 1 with pericarditis and 1 with an anomalous coronary artery origin. Testing performed outside of guideline recommendations demonstrated only incidental findings. Patients returning for persistent symptoms did not have cardiac disease. The pattern of care for the NECCA practices and BCH differed minimally. CONCLUSIONS: By using SCAMPs methodology, we have demonstrated that chest pain in children is rarely caused by heart disease and can be evaluated in the ambulatory setting efficiently and effectively using minimal resources. The methodology can be implemented regionally across a wide range of clinical practice settings and its approach can overcome a number of barriers that often limit clinical practice guideline implementation.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=24019419&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1542/peds.2013-0086
dc.subjectAdolescent
dc.subjectAmbulatory Care
dc.subjectChest Pain
dc.subjectChild
dc.subjectDisease Management
dc.subjectEchocardiography
dc.subjectElectrocardiography
dc.subjectFemale
dc.subjectFollow-Up Studies
dc.subjectGuideline Adherence
dc.subjectHeart Diseases
dc.subjectHumans
dc.subjectMale
dc.subjectPediatrics
dc.subjectPractice Guidelines as Topic
dc.subjectRadiography, Thoracic
dc.subjectYoung Adult
dc.subjectCardiology
dc.subjectCardiovascular Diseases
dc.subjectPediatrics
dc.titleRegional implementation of a pediatric cardiology chest pain guideline using SCAMPs methodology
dc.typeJournal Article
dc.source.journaltitlePediatrics
dc.source.volume132
dc.source.issue4
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/faculty_pubs/742
dc.identifier.contextkey7693390
html.description.abstract<p>BACKGROUND AND OBJECTIVES: Chest pain is a complaint for which children are frequently evaluated. Cardiac causes are rarely found despite expenditure of considerable time and resources. We describe validation throughout New England of a clinical guideline for cost-effective evaluation of pediatric patients first seen by a cardiologist for chest pain using a unique methodology termed the Standardized Clinical Assessment and Management Plans (SCAMPs).</p> <p>METHODS: A total of 1016 ambulatory patients, ages 7 to 21 years initially seen for chest pain at Boston Children's Hospital (BCH) or the New England Congenital Cardiology Association (NECCA) practices, were evaluated by using a SCAMPs chest pain guideline. Findings were analyzed for diagnostic elements, patterns of care, and compliance with the guideline. Results from the NECCA practices were compared with those of Boston Children's Hospital, a regional core academic center.</p> <p>RESULTS: Two patients had chest pain due to a cardiac etiology, 1 with pericarditis and 1 with an anomalous coronary artery origin. Testing performed outside of guideline recommendations demonstrated only incidental findings. Patients returning for persistent symptoms did not have cardiac disease. The pattern of care for the NECCA practices and BCH differed minimally.</p> <p>CONCLUSIONS: By using SCAMPs methodology, we have demonstrated that chest pain in children is rarely caused by heart disease and can be evaluated in the ambulatory setting efficiently and effectively using minimal resources. The methodology can be implemented regionally across a wide range of clinical practice settings and its approach can overcome a number of barriers that often limit clinical practice guideline implementation.</p>
dc.identifier.submissionpathfaculty_pubs/742
dc.contributor.departmentDepartment of Pediatrics, Division of Cardiology
dc.source.pagese1010-7


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